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Orthorexia, or orthorexia nervosa is a term coined by Steven Bratman, a Colorado MD, to denote an eating disorder characterized by excessive focus on eating healthy foods. In rare cases, this focus may turn into a fixation so extreme that it can lead to severe malnutrition or even death.^[1][2]

BackgroundEdit

Bratman coined the term in 1997 from the Greek orthos, "correct or right", and orexis for "appetite"^[3]. Literally "correct appetite", the word is modeled on anorexia, "without appetite", as used in definition of the condition anorexia nervosa. Bratman describes orthorexia as an unhealthy obsession (as in obsessive-compulsive disorder) with what the sufferer considers to be healthy eating. The subject may avoid certain foods, such as those containing fats, preservatives, animal products, or other ingredients considered by the subject to be unhealthy; if the dietary restrictions are too severe or improperly managed, malnutrition can result. Orthorexic sufferers have specific feelings about the foods they are avoiding. Products that are preserved can be considered dangerous and industrial products can be seen as artificial, whereas biological products can be seen as healthy ^[4]. Bratman asserts that "emaciation is common among followers of certain health food diets, such as rawfoodism, and this can at times reach the extremes seen in anorexia nervosa." In addition, he claims that "anorexic orthorexia" can be as dangerous as anorexia. However, he states, "the underlying motivation is quite different. While an anorexic wants to lose weight, an orthorexic does not desire to become thin^[5] but wants to feel pure, healthy and natural. Eating disorder specialists may fail to understand this distinction, leading to a disconnect between orthorexic and physician."^[1][6]

According to the Macmillan English Dictionary, the word is entering the English lexicon.^[7].

Diagnostic criteria Edit

Although it is not an official medical diagnosis, and it is not listed in the DSM-IV^[8] or planned to be included in the DSM-V to be published May 2013^[9], it is still used as a diagnosis by some practitioners who have documented the damaging results of the condition as they have seen in their practices.^[10][11][12]

As of January 2007, two peer-reviewed studies have been published on the condition. ^[13][14] In the studies, Donini et al. define orthorexia nervosa as a "maniacal obsession for healthy foods" and propose several diagnostic criteria.^[13] Sufferers of orthorexia often display symptoms consistent with obsessive-compulsive disorder and have an exaggerated concern with healthy eating patterns. Like anorexia, however, these obsessive compulsive symptoms may be an effect of starvation rather than a cause of the disorder.^[15] A diagnostic questionnaire has been developed for orthorexia sufferers, similar to questionnaires for other eating disorders.^[14] Bratman proposes an initial self-test composed of two direct questions: "Do you care more about the virtue of what you eat than the pleasure you receive from eating it?... Does your diet socially isolate you?" ^[16]. Other questions concerning those who may be suffering from orthorexia provided by Davis on the WebMD (2000) website are: Do they spend more than 3 hours a day thinking about healthy foods? When they eat the way they're supposed to, do they feel in total control? Are they planning tomorrow's menu today? Has the quality of their life decreased as the quality of their diet increased? Have they become stricter with themselves? Does their self-esteem get a boost from eating healthy? Do they look down on others who don't eat this way? Do they skip foods they once enjoyed in order to eat the "right" foods? Does their diet make it difficult for them to eat anywhere but at home, distancing them from family and friends? Do they feel guilt or self-loathing when you stray from their diet? If yes was answered to two or more questions, the person may have a mild case of orthorexia. ^[17]

Symptoms and Theory Edit

Symptoms of orthorexia nervosa may include obsession with healthy eating, and emaciation among other things. Orthorexic subjects typically have specific feelings towards different types of food. They tend not to eat out as much because they do not trust the preparation of foods other than what they have prepared.^{[citation needed]} The obsession for healthy foods could come from a number of sources such as family habits, society trends, economic problems, recent illness, or even just hearing something negative about a food type or group, which then leads them to ultimately eliminate the food or foods from their diet.^[18] According to the abstract of a 2004 study quoted on PubMed, a service of the National Institutes of Health, "The analysis of the physiological characteristics, the social-cultural and the psychological behaviour that characterises subjects suffering from ON shows a higher prevalence in men and in those with a lower level of education."^[13]

Biology of orthorexia nervosa Edit

There has been no investigation into whether there may be a biological cause specific to orthorexia nervosa. However, Donini et al. link orthorexia to a food-centered manifestation of obsessive compulsive disorder, which has a lot to do with control^[19]

See also Edit

• Comfort food
• Emotional eating
• Diet
• Coping (psychology)
• Food guide pyramid

ReferencesEdit

External linksEdit

• Steven Bratman official page
• BBC News article - 'I am an orthorexic'
• EDNOS & Other Types (includes Orthorexia Nervosa)
• Orthorexia Nervosa
• Orthorexia: Good Diets Gone Bad
• includeonly>Cochrane, Kira. "When healthy eating turns into a disease", The Guardian, 2006-10-10. Retrieved on 2009-07-09.
• Marketplace Radio Segment - 'An unhealthy obsession with eating healthy?'
• Orthorexia Nervosa Online Resource
• The 10 signs of orthorexia: Summary of Dr. Bratman's diagnostic standards